2017-07-25T09:32:28-05:00 2016-12-31 450250958 EIDE BAILLY LLP 4310 17TH AVE S PO BOX 2545 FARGO ND 581082545 990 2016-01-01 450274012 American Lutheran Homes Inc AMER 7012393000 201 South University Drive Fargo ND 58103 Shawn Stuhaug President/CEO 7012393000 2017-07-14 1 LISA CHAFFEE CPA P00193453 7012398500 2017-07-14 198.135.125.169 2017-07-14 13:49:30 CD P 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 385FD7544B689D76E9DA9F221308BA92DD4DD75D 2016 2021-01-29 14:40:06Z Bethany On University Shawn Stuhaug 201 South University Drive Fargo ND 58103 23445339 0 X www.bethanynd.org X 1959 ND Provide long term care services 11 10 1138 73 0 0 2500 10000 21387137 23430502 -3362 -21286 0 0 21386275 23419216 140987 0 0 0 15122067 15669520 0 0 0 6401617 7424679 21664671 23094199 -278396 325017 31463087 35264400 20970946 24760165 10492141 10504235 X To provide living opportunities in a senior community shaped by Christian values. 0 0 20817427 23430502 Service to the community American Lutheran Homes, Inc. (ALH) operates as a charitable organization consistent with the requirements of Internal Revenue Code Section 501(c)(3). ALH provides long term care services including skilled nursing care, assisted living and basic care. ALH does not discriminate against individuals in the admissions process or in the delivery of care with regard to ability to pay for services. The assisted living facilities operated by ALH primarily serve low-income elderly residents. The Organization's cash reserves are generally applied to expansion and replacement of existing facilities and equipment, amortization of mortgages, improvement in resident care, training and education, and community benefit activities. The governing board of ALH is made up of leaders in the Fargo-Moorhead business community. Consistent with its charitable mission, ALH provides community benefit to the area served. In 2016, community benefit activities included: - Speakers' bureau services - provides free educational sessions to agencies and individuals in the community on topics such as: Bethany on the Grow Advance Directive EducationCareers in Long Term Care Early Dementia Care Activities with a Purpose The A, B, C & Ds of MedicareFacing Our Later Days in FaithManaging Your Resources - Estate Planning Activity With A Purpose Volunteerism - The Rewards Of Giving Yourself - Groups to which our speaker's bureau presented information included service clubs, churches, parish nurse groups, and senior centers. - Endings and Beginnings - a support group for family members dealing with a loved one diagnosed with Alzheimer's disease - Provides virtual dementia / sensitivity training to employees and community members. This training program teaches participants about the challenges and frustrations of an elderly nursing home resident in managing day-to-day tasks and activities. Participants learn through active involvement in a simulation exercise what is it like to be challenged by issues like hearing impairment, deteriorating vision, dementia, loss of control of their environment, communication difficulties, etc. - Volunteerism - coordinates a volunteer program that included approximately 73 volunteers giving over 15,405 hours of service, providing mental stimulation and emotional support to ALH's 304 elderly residents. Volunteers included members of sponsoring churches, Experience Works program volunteers, and many student volunteers from the community's schools - elementary, middle, high schools and colleges. - Tuition assistance and student loan repayment bonus opportunities - ALH recognizes that to continuously improve the Organization's value to our community and our residents, to encourage life-long learning among employees and to achieve an "employer of choice" status, it is in our best interest to provide opportunities that will assist eligible employees in pursuing formal, healthcare-related educational opportunities.- School Partnerships - ALH works with area nursing and other healthcare-related programs to provide on-site training opportunities for students. In 2016, we had 114 nursing students complete clinical experiences at our facility. We provide a CNA training program for individuals in the Fargo-Moorhead community interested in pursuing a career as a nursing assistant. We also provided clinical site experience for an outside CNA training program and dietetic students, and internship opportunities for students in social worker programs, LTC administration and pre-med students for observation of Alzheimer's residents. We hosted visiting students from several higher education classes including: gender and aging class from North Dakota State University (NDSU) Department of Human Development; NDSU Dietetics class; Minnesota State University - Moorhead Gerontology class and administrative interns; long term care planning class from NDSU's interior design program; Concordia College class from the long term care administration program. - Assessment and referral services - our staff help to refer individuals needing long term care services to the appropriate agency in the community. ALH licensed social workers provide guidance with medical assistance applications for residents/families. - Through in-kind gifts of equipment and other materials, ALH helps support the work of the following agencies: HERO, Great Plains Food Bank, Dakota Boys and Girls' Ranch, New Life Center, Rape and Abuse Crisis Center, YWCA, Lake Agassiz Habitat for Humanity, Hospice of the Red River Valley, Data School of Nursing. - Community support - ALH provides meeting room space and accommodations for non-profit organizations and community groups. Several of our resident activity programs are open to community members. In 2016, these activities included special Christmas events, wellness fair and several food festivals. ALH also supports and sponsors the Northern Plains Conference on Aging and Disability, as well as sponsoring the RSVP+ program. Facility space is open to use by outside groups for meetings, performances, activities, funeral/memorials services, music recitals, etc. Meals are provided for family members of ALH residents at a reduced cost. In 2016 ALH hosted the following programs which were open to the public: Advance Directives: talking to family about future care, and Preparing for Long Term Care. Contributions were made to: First Assembly Church, New Life Center, Valley Senior Services, Jefferson Area Neighborhood Association, and Center for New Americans. ALH also provided classroom instruction and clinical training for the Data School of Nursing class. - Other - in addition to the activities above, ALH also organizes employee participation in fundraising activities for Cass-Clay United Way and the Alzheimer's Association. There are also representatives from ALH on non-profit boards and civic organizations that work to improve the quality of life in the Fargo-Moorhead area. ALH's President/CEO serves on HERO's (Health Equipment Recycling Organization) Board of Directors, and the Ethos Board of Directors. He also serves on various committees of the North Dakota Long Term Care Association (NDLTCA). ALH's Chief Financial Officer serves on the Ethos Home Care Board and the Funding/Reimbursement Committee of the NDLTCA. The Senior Executive of Resident Care serves on the FM Clinical & Academic Collaborative, Great Plains & Lake Superior Quality Innovation Networks, Resident Issues Committee of the NDLTCA, the Ethos Home Care Advisory committee, and as a NCLEX test reviewer/item review for the National Boards of Nursing. The Senior Executive of Human Resources serves on a panel for the MState New American Program, the Ethos Advisory Committee, and the Find the Good Life recruiter network (a collaborative group working to recruit future workers to North Dakota). The Senior Executive of Medicare/Contracted Services serves on the board for the (NADONA). ALH's Senior Executive of Support Services is on the Dietetics Advisory Committee for North Dakota State University, Concordia College's Dietetic Program Advisory Board, and the Advisory Board for the Culinary Arts program at MState-Moorhead. The Senior Executive of Housing/Assisted Living is a Board member of the Fargo West Rotary service club, and serves on the National Center for Assisted Living Not-For-Profit Committee. The Senior Executive of Development and Community Relations serves on the Education Committee and chairs the Senior Level Task Force for the Association of Lutheran Development Executives, and serves on the Public Affairs Fargo-Moorhead-West Fargo Chamber Committee. He also serves on the Ethos Advisory Committee. ALH's Director of Bethany Personal Care Services is on the Advisory Board for the North Dakota State University Nursing program. The following is specific information relating to ALHs' care provided: Bethany on University skilled care - services provided, 172 nursing home beds: 61,644 days of care and 553,677 employee hours (total expenses including management and general = 18,376,407) Bethany Towers I - basic care services, 53 beds: 18,696 days of care. BT I had 54,183 employee hours (total expenses including management and general = 2,044,954). Bethany Towers II - assisted living services, 67 units - 21,908 days of care and basic care services, 12 beds: 4,282 days of care. Bethany Towers II had 25,122 employee hours (total expenses including management and general = 1,834,275) 20817427 1 1 0 0 0 0 0 0 1 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 56 0 1 1138 1 0 0 0 0 0 0 0 0 0 0 X 11 10 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 1 1 0 X Jane Kelly 7012393226 201 South University Drive Fargo ND 58103 X John Hertsgaard Chair 1.00 3.00 X X 0 0 0 Al Erickson Vice Chair 1.00 3.00 X X 0 0 0 Roger Olson Treasurer 1.00 3.00 X X 0 0 0 Jean Bokinskie Secretary 1.00 3.00 X X 0 0 0 David Glatt Trustee 2.00 4.00 X 7920 5280 0 Mary Johnson Trustee 1.00 3.00 X 0 0 0 Jerilynn Brantner-Adams Trustee 1.00 3.00 X 0 0 0 Linda O'Halloran Trustee 1.00 3.00 X 0 0 0 Stacie Heiden Trustee 1.00 3.00 X 0 0 0 Kris Sheridan Trustee 1.00 3.00 X 0 0 0 Rhonda Ketterling Trustee 1.00 3.00 X 0 0 0 Shawn Stuhaug President/CEO 28.00 22.00 X 257410 0 30524 Jane Kelly CFO 28.00 22.00 X 181643 0 18957 Dawn Hummel Senior Exec of Resident Ca 30.00 20.00 X 116255 0 7302 563228 5280 56783 3 0 1 0 Meinecke-Johnson Company 5 14th St N Fargo ND 58102 General Contractor 1986802 Robert Wilm DBA Northern Plains Mechanic 2421 Great Northern Drive Fargo ND 58102 Mechanical Contractor 1500005 RehabCare Group East Inc 7733 Forsyth Blvd Suite 1700 St Louis MO 63105 Contract Therapy 593804 Otis Elevator Company 1 Farm Springs Road Farmington CT 06032 Elevator Maintenance 104050 4 10000 10000 Resident Service Revenue 623000 22384757 22384757 Other Supporting Revenue 900099 1019878 1019878 25867 25867 23430502 4837 4837 26123 -26123 -26123 -26123 23419216 23430502 0 -21286 496669 7920 488749 12731108 12085207 645901 177426 158630 18796 1321029 1135495 185534 943288 863062 80226 6513 6513 69802 69802 1722349 1722349 1829062 1352551 476511 613112 613112 78152 78152 54792 30349 24443 463263 463263 1705918 1705918 254806 254806 Medical Supplies 503308 503308 Bad Debt Expense 95321 95321 Memberships 25491 25491 2790 2790 23094199 20817427 2276772 0 1482264 1318190 1341216 1983719 5581463 5379252 152033 140192 213760 187408 45978245 22172287 20131212 23805958 606616 670556 1954523 1779125 31463087 35264400 3911652 3688678 15467214 19610054 63523 41592 645493 614720 113847 106794 769217 698327 20970946 24760165 X 10492141 10504235 10492141 10504235 31463087 35264400 X 325017 -312923 X 0 1 X 1 0 X 5643 1489 4757 2500 10000 24389 18431542 18828233 19511160 21387137 23430502 101588574 18437185 18829722 19515917 21389637 23440502 101612963 0 0 0 101612963 22619 15275 9474 5584 4837 57789 22619 15275 9474 5584 4837 57789 -564 -564 18459240 18844997 19525391 21395221 23445339 101670188 0.99940 0.99930 0.00060 0.00080 X Schedule A, Part III, Line 12, Explanation of Other Income: Other Revenue - 2012 Amount: $ -564. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 1 X 1023011 1023011 32397542 15949632 16447910 8983519 5678312 3305207 3574173 544343 3029830 23805958 Related Party Receivables 1387625 Bed Licenses 391500 1779125 Asset Remediation Obligation 698327 698327 X 22399338 0 22399338 1019878 1019878 23419216 22074321 0 22074321 1019878 1019878 23094199 Part IV, Line 2b: The Organization acts as custodian for the funds of the residents. These funds are included in cash and cash equivalents and a corresponding liability is included in accounts payable-trade in the financial statements. Resident trust funds totaled $41,592 and $63,523 at December 31, 2016 and 2015. Part X, Line 2: American Lutheran Homes is a North Dakota nonprofit corporation located in Fargo, North Dakota and has been recognized by the Internal Revenue Service as exempt from federal income taxes under Internal Revenue Code Section 501(c)(3). The organization is annually required to file a Return of Organization Exempt from Income Tax (Form 990) with the IRS. In addition, it is subject to income tax on net income that is derived from business activities that are unrelated to their exempt purpose. The organization has determined they are not subject to unrelated business income tax and have not filed an Exempt Organization Business Income Tax Return (Form 990T) with the IRS. American Lutheran Homes believes that it has appropriate support for any tax positions taken affecting the annual filing requirements, and as such, does not have any uncertain tax positions that are material to the consolidated financial statements. American Lutheran Homes would recognize future accrued interest and penalties related to unrecognized tax benefits and liabilities in income tax expense if such interest and penalties are incurred. Part XI, Line 4b - Other Adjustments: Dining Services Revenue Recorded in Expenses for Financial Statement 1,019,878. Part XII, Line 4b - Other Adjustments: Dining Services Revenue Recorded in Revenue on Form 990 1,019,878. X X X X 0 0 0 0 0 0 0 1 0 Shawn Stuhaug President/CEO 202600 0 54810 0 0 0 9197 0 21447 0 288054 0 0 0 Jane Kelly CFO 154443 0 27200 0 0 0 7450 0 11602 0 200695 0 0 0 Part I, Line 7 CEO and CFO received a bonus as determined by the Board of Directors. The bonus is based on review of performance and progress related to a specific work plan. A Cass County North Dakota 456002205 2004-12-31 4607000 Refunding Revenue Bonds-Series 2004A to Refund 1996, 1998, 2001 Bonds 0 0 0 B Cass County North Dakota 456002205 2010-10-01 6400000 Construct & Equip Retirement Living Campus 0 0 0 C City of Argusville North Dakota 450310938 2013-12-20 10000000 Construct & Equip Basic Care & Assisted Living Facility Series B&C 0 0 0 D City of Harwood North Dakota 450371534 2013-12-20 10000000 Construct & Equip Basic Care & Assisted Living Facility Series A 0 0 0 A 3829675 4607000 38881 4568119 2004 1 0 1 1 B 1020748 6400000 54857 6345143 2010 0 0 1 1 C 328020 10000000 35000 3893220 6071780 0 0 0 1 D 10000000 5660 35000 9965000 2016 0 0 1 1 B 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 C 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 D 0 0 0 0 0.00000 0.00000 0.00000 0 0 0 A 0 0 1 0 0 0 0 0 0 B 0 0 1 0 1 0 0 0 0 C 0 0 0 0 1 0 0 0 0 D 0 0 0 0 1 0 0 0 0 A 0 B 0 C 0 D 0 Form 990, Part VI, Section A, line 2 The CEO and CFO both have a business relationship with each other and all of the Board Members, as the CEO and CFO are officers of all related nonprofits listed on Schedule R of which the board members all serve as well. Form 990, Part VI, Section A, line 6 Bethany Homes, Inc. is the sole member of the Corporation. Form 990, Part VI, Section A, line 7a The Board of Directors is elected at the annual meeting of the Board of Trustees of the Member. The Member has the right to fill any vacancies during the year. The Member may also remove any directors with or without cause. Form 990, Part VI, Section A, line 7b The following actions by the Board of Directors require the approval of the Board of Trustees of the Member: - Establishment of annual operating budget - Sale, lease or encumbrance of any corporation real property - Unbudgeted capital expenditures exceeding amounts for which the President/CEO is specifically authorized to approve Form 990, Part VI, Section A, line 8b There are no committees with the broad authority to act on behalf of the governing board. Form 990, Part VI, Section B, line 11b The Form 990 is reviewed by the CFO and CEO and then provided to the Board for review prior to filing with the IRS. Form 990, Part VI, Section B, line 12c Board officers and directors, as well as officers of the Organization, complete a conflict of interest questionnaire on an annual basis. The Board reviews the conflicts to determine if a conflict exists. The individual with the conflict is required to abstain from voting if the conflict comes up in the board meeting where a decision needs to be made. This is a standing agenda item at each board meeting. Form 990, Part VI, Section B, line 15 The Executive Committee of the board meets to determine the compensation of the President/CEO. Compensation is determined by gathering comparable data, including salary surveys, personal contacts, 990 data, and evaluating criteria such as knowledge/experience, longevity, job performance, etc. Periodically, a consultant is brought in to assist in the evaluation process to test for fairness and reasonableness of compensation levels. Consultant involvement was last implemented in 2011. The Executive Committee reviews the data and recommends the compensation package, which is reviewed and approved at the full board level. The process for determining compensation for the President/CEO is implemented on an annual basis. The President/CEO determines the CFO compensation in the same manner the Executive Committee determines compensation for the President/CEO. The President/CEO also reviews the information with the Executive Committee. The process for determining compensation for the CFO is implemented on an annual basis. Form 990, Part VI, Section C, line 19 The Organization's governing documents, conflict of interest policy, and financial statements are available upon request. Form 990, Part VII, Section A: David Glatt serves as a board member 1 hour per week. He serves an additional two total hours per week as a Medical Director for both Bethany on 42nd and American Lutheran Homes. Compensation shown on Part VII, Column D is compensation paid to Sanford Health for his services as Medical Director to American Lutheran Homes, Inc. Compensation shown on Part VII, Column E is compensation paid to Sanford Health for his services as Medical Director to Bethany on 42nd. Form 990, Part XI, line 9: Intercompany Transfer to Bethany Homes, Inc. -312,923. Bethany Home Health Care 201 S University Drive Fargo ND 58103 450433045 Promotion of health ND 501(c)(3) Line 10 Bethany Homes Inc 1 Bethany on 42nd 201 S University Drive Fargo ND 58103 261087740 Long-term care services/Assisted living/Independent living ND 501(c)(3) Line 10 Bethany Homes Inc 1 Bethany Homes Inc 201 S University Drive Fargo ND 58103 450394181 Fundraising ND 501(c)(3) Line 10 N/A 1 0 0 0 0 1 0 0 0 0 0 0 1 1 1 0 0 1 1 0 Bethany on 42nd Q 11839883 General Ledger Bethany Homes Inc Q 171819 General Ledger Bethany Home Health Care Q 537418 General Ledger Bethany Homes Inc R 312923 General Ledger